What are the responsibilities and job description for the Encounters System Analyst II position at HMSA?
Employment Type
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $59,000 - $116,000
Note: Individuals typically begin between the minimum to middle of the pay range
Position is responsible for optimizing the completeness and accuracy of encounter data submissions. Role requires collaboration with other departments to maximize quantity and quality of encounter information. Position is responsible for sustaining subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally and externally as needed.
Position also assists with audits, ongoing submissions, and other government finance deliverables.
Minimum Qualifications
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $59,000 - $116,000
Note: Individuals typically begin between the minimum to middle of the pay range
Position is responsible for optimizing the completeness and accuracy of encounter data submissions. Role requires collaboration with other departments to maximize quantity and quality of encounter information. Position is responsible for sustaining subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally and externally as needed.
Position also assists with audits, ongoing submissions, and other government finance deliverables.
Minimum Qualifications
- Bachelor's degree and three year related experience; or an equivalent combination of education and experience.
- Working knowledge of claims, health plan financial data, and health industry structure.
- Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
- Explains complex information to others in straightforward situations.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
- Conceptual knowledge of SQL, SAS, or MicroStrategy.
- Sustains strong knowledge of encounter system processes within HMSA and external partners.
- Coordinates and reconciles data exchange with external entities, monitoring quality.
- Researches complex claim-member-provider scenarios to determine root cause of data submission errors.
- Coordinates activities with internal staff to optimize encounter submission processes.
- Actively participates in the planning, implementation, and testing of projects to increase the scope or efficacy of encounters submission.
- Analyzes project objectives, data sources, and methodology.
- Provides data to support financial reporting.
- Monitors government/vendor requirements changes. Determines and communicates impact.
- Ensures submission methodologies are compliant with published guidance.
Salary : $59,000 - $116,000